It’s recommended that women receive periodic mammograms after they’ve been treated for early-stage breast cancer. But according to a new study, up to 30% of women don’t receive the recommended breast screening after their surgery.

The study, published in the Journal of the National Comprehensive Cancer Network, analyzed the medical bills of 36,000 women under the age of 65 provided and commercial data from up to 100 insurance companies.

Researchers found that many women who received early breast cancer surgery received imaging for other parties of their bodies including PET scans and CT scans.

These imaging scans aren’t recommended for women who’ve undergone surgery for early-stage breast cancer. Up to 32% of women had at least one non-breast imaging test.

This study is only the latest in what many medical researchers have said is a problematic use of diagnostic imaging. While imaging can be useful, overuse can expose patients unnecessarily to radiation and can put patients at greater risk for misdiagnosis.

Industry experts say one of the best ways to improve the quality of American healthcare is to understand how medical care varies across the nation.

Dr. Benjamin Franc of the University of California, San Francisco, says the reason why imaging may be overused in some areas of the U.S. is because of the differences in how doctors train across the country.

“Everyone does something a little bit different and it can translate into real costs and real harm to patients,” said Franc.

Unlike past studies, the Cancer Network study offers medical researchers a look into privately insured patients. Compared to Medicare, which releases general data to the public, private insurances are less commonly studied.

The women who were analyzed in the study received surgery for early breast cancer between 2010 and 2012. The surgeries included mastectomies and lumpectomies.

The information provided to the researchers didn’t include detailed information regarding the stage of the women’s cancer. Because of this, researchers made estimates on the stage of cancer based on their treatments.

Dr. Patricia Ganz, the director of cancer prevention and control research at the University of California, Los Angeles, says one of the potential reasons why imaging is overused on areas of the body that aren’t the breasts is that the patients may be anxious about their cancer returning. These patients could ask their doctors for more screening to ease that anxiety.

Ganz says another potential reason is that doctors may choose to order imaging tests rather than consider the reasons to avoid them because they’re often busy.

“It’s so easy for the doctor to order a test,” said Ganz, who also wrote guidelines for when to use imaging for cancer patients.

Although wellness culture has taken on a larger role in the U.S. (the global cryotherapy market is expected to reach $5.6 billion by 2024), researchers still highly recommend those who’ve undergone treatment for early-stage breast cancer receive periodic mammograms throughout the year.

Mammography can help reduce the risk of dying from breast cancer by 20% to 40%. This is because mammography detects the breast cancer when it’s still in its early stages and hasn’t yet shown symptoms.

For instance, bone cancer may cause symptoms such as pain, swelling, or fractures (which typically heal in two to 10 weeks). But breast cancer symptoms involve lumps or masses in the breast and changes in how your breasts look and feel. These changes may go undetected, which is why breast screening and mammography are crucial to your health.

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